老年结肠癌并发急性肠梗阻的外科治疗

Surgical treatment of geriatric colon cancer with acute intestinal obstruction

目的：探讨老年结肠癌并发急性肠梗阻的外科治疗。方法回顾分析我院60岁以上40例结肠癌并发肠梗阻外科手术治疗临床资料，术前对梗阻部位置入肠腔内支架21例，急诊手术3例，择期手术37例；30例行根治性切除术，8例行姑息性切除术，2例仅行横结肠造口术。结果1例死于肺部感染呼吸衰竭，其余全部治愈。结论对全身情况较差的老年结肠癌并发肠梗阻患者，先通过梗阻部位置入肠腔内支架以解除梗阻和保守治疗后，选择合适时机给予手术的治疗，可减少并发症发生，能收获良好的治疗效果。

Objective To explore the surgical treatment of colon cancer complicated with acute intestinal obstruction for geriatric patients.Methods The clinical data of 40 geriatric colon cancer patients（age〉60 years）with acute intestinal obstruction were analyzed retrospectively.Stent implant was performed in 21 cases at preoperation.There were 3 cases of emergency operation and 37 cases of selec-tive operation.Radical resection was performed in 30 cases,palliative resection in 8 cases,and transverse colostomy in 2 cases.Results One patient died of pulmonary infection and respiratory failure.The other patients were all cured.Conclusion For geriatric patients with colon cancer,acute intestinal obstruction and poor general conditions,stent implant should be performed to relieve the obstruction first.After the conservative treatment,an appropriate timing should be selected for the following surgical management. These may reduce the occurrence of complications and obtain good treatment results.